Primary diagnosis of angiosarcoma by fine needle aspiration: Lessons learned from 3 cases

Angiosarcomas are rare malignancies arising from cells of endothelial origin and are aggressive sarcomas that can occur in any anatomic site. They are reported to have predilection for the scalp, extremities and breasts. The incidence of these tumors is increasing, which has been suggested to be attributable to the growing use of radiotherapy to treat breast and other malignancies. There is currently limited literature describing the primary cytologic diagnosis of angiosarcoma on fine needle aspirate material. We describe the findings of three cases of angiosarcoma diagnosed by fine needle aspiration. Our three cases offer distinct radiologic, clinical and cytopathologic points‐of‐view: a thyroid angiosarcoma, a mediastinal angiosarcoma and a skin angiosarcoma. The cytomorphology of angiosarcoma is characterized by large highly atypical spindle to epithelioid cells with abundant cytoplasm in dispersed single cells or loose aggregates. The nuclei are large and pleomorphic with vesicular chromatin and prominent nucleoli. Mitoses are readily identified. The background can be bloody and/or necrotic. Occasional intracytoplasmic lumens are a helpful morphologic feature suggesting vascular differentiation. HHV‐8 immunostaining may aid in the differential diagnosis with Kaposi sarcoma while epithelioid hemangioendothelioma can be distinguished based on morphologic features. Given the metastatic potential and high mortality rate associated with these tumors, this entity is an important consideration in the contexts herein described.     

超声引导与透视引导下膝下动脉逆行穿刺在下肢动脉闭塞双向成形术中应用对比研究

目的 比较超声引导下膝与透视引导下穿刺动脉逆行穿刺在下肢动脉闭塞双向成形术中的成功率及并发症。方法 回顾性分析首都医科大学附属北京世纪坛医院自2016年5月至2019年5月因下肢动脉闭塞行双向开通术的67例病人资料,根据逆穿引导方法的不同分为超声组和透视组,其中超声组32例,透视组35例,分析两组穿刺成功率、手术成功率、通畅率及相关并发症情况。结果 67例病人逆行穿刺均获得成功,超声组在平均穿刺时间及穿刺次数上均明显少于透视组（P＜0.05）;两组术后Rutherford分级较术前均明显改善,同时,ABI值较术前均明显升高（P＜0.05）;超声组与透视组6个月的一期通畅率分别为80％和76.5％,12个月的一期通畅率分别为71.4％和73.3％,两组间通畅率比较差异无统计学意义;常见并发症为穿刺点出血、血肿及穿刺血管痉挛,两组间并发症发生率差异无统计学意义。结论 超声引导下穿刺较透视引导下穿刺可以明显缩短穿刺时间及减少穿刺次数,有临床应用价值。     

Hyperechoic malignancies of the breast: Underlying pathologic features correlating with this unusual appearance on ultrasound

Hyperechogenicity in the breast on ultrasound (US) is usually regarded as a benign feature with only rare hyperechoic malignancies reported to date. In this study, we evaluated the pathologic findings on core needle biopsy of hyperechoic lesions and investigated the histologic features in malignancies that give rise to an echogenic pattern. A total of 163 core needle biopsies (CNB) were performed for “hyperechoic” or “echogenic” lesions between 1/1/05 and 7/31/17. Lesions were classified based on the proportion of hyperechoic areas identified. We found that all lesions with a homogenous hyperechoic pattern (>90% hyperechoic) were benign (n = 17), regardless of the type of margins. Malignancies were found in 21% (7/34, six invasive carcinomas and one lymphoma) of heterogenous lesions with ≥50% hyperechoic areas (all with noncircumscribed margins) and in 31% of lesions with <50% hyperechoic areas (19/61, 14 invasive carcinomas, two lymphomas, and three metastases), including five with circumscribed margins (one invasive carcinoma, one lymphoma, and three metastases). Two major US patterns were identified in malignant lesions, those with a hypoechoic center and hyperechoic rim, corresponding to a central tumor area with dense stroma and tumor cells infiltrating adipose tissue at the periphery (“rim pattern”), and a second “dispersed pattern” with hyperechoic areas distributed throughout the lesion. Hyperechoic malignancies were found to be comprised of a complex intermixture of elements of differing echogenicity including tumor cells, adipose tissue, and fluid (in tubules, stromal clefts, or blood vessels). Our findings support the importance of radiologists specifying the echogenic pattern of hyperechoic lesions, as heterogenous lesions are associated with a higher risk of malignancy and pathologists should be alert to the associated pathologic findings.     

Postoperative pain of mixed hemorrhoid treated by embedding needles in Èrbái ( EX-UE 2)

ObjectiveTo explore the effectiveness of treating postoperative pain of mixed hemorrhoid by embedding needles in Èrbái (

EX-UE 2) and find possible ways for relieving postoperative pain of mixed hemorrhoids.Methodspress needle (SEIRIN pyonexes) were embedded in EX-UE 2 of patients with postoperative pain of mixed hemorrhoid, once a day and totally 7 treatments. Visual analogue scale (VAS) values were adopted for evaluation.ResultsComplete remission of clinical pain was observed in 34 cases, accounting for 50.00%; significantly effective in 19 cases, accounting for 27.94%; effective in 13 cases, accounting for 19.12%; and ineffective in 2 cases, accounting for 2.94%; the total effective rate was 97.06%.ConclusionsThe therapy of treating postoperative pain of mixed hemorrhoid by embedding press needle in EX-UE2 is effectively satisfactory.     

Biomechanics of a new atraumatic surgical needle holder

It is the purpose of this report to design, develop, and evaluate a needle holder whose jaws improve needle-holding security without altering the geometry of the curved surgical needle. The configuration of the jaws of this new needle holder is curved, conforming to the curvature of the surgical needle. A biomechanical study of this curved surgical needle holder demonstrates that it holds the curved needle securely without needle deformation.     

CT导向下经皮穿刺活检及介入治疗的临床应用

目的:探讨CT导向下经皮穿刺活检及介入治疗术的临床应用价值。方法:在CT导向下行诊断目的56例,治疗目的32例,诊断及治疗双目的21例。穿刺部位:头、颈部7例,胸部48例,腹部47例,躯干及四肢7例,共109例112个病灶。结果:112个病灶穿刺114针次,穿刺一次成功率100%,确诊96.1%,治疗有效率86.8%,并发症10.1%。结论:CT导向下经皮穿刺活检及介入治疗术属微创伤性技术,具有安全、可靠、有效、成功率高、并发症少、操作简便快捷等特点,是诊断、鉴别诊断、提高诊治成功率的重要手段。     

银质针导热疗法对腰肌劳损的临床疗效观察

目的观察并比较银质针导热疗法与传统温针灸法对腰肌劳损的治疗效果。方法选取确诊腰肌劳损患者110例,随机分为治疗组(银质针组)和对照组(传统温针灸组)各55例,治疗1、4、8周后对疼痛程度的变化进行随访,并于治疗8周后两种治疗方法的效果进行评价。结果 8周后,治疗组有效率100%,对照组有效率89.09%。治疗组远期疗效优于对照组。结论银质针导热疗法优于传统温针灸法。